内镜下金属钛夹止血联合药物治疗非静脉曲张性上消化道出血的临床疗效

Clinical efficacy of endoscopic metal titanium clip hemostasis combined with drugs in the treatment of non variceal upper gastrointestinal bleeding

目的探究内镜下金属钛夹止血联合药物治疗非静脉曲张性上消化道出血的临床疗效。方法选取2019年10月至2020年10月本院收治的100例非静脉曲张性上消化道出血患者作为研究对象,按照随机数字表法分为对照组与观察组,各50例。对照组行内镜下药物止血治疗,观察组在对照组基础上行金属钛夹止血治疗,比较两组临床疗效、恢复情况、治疗前后应激因子[肿瘤坏死因子-α(TNF-α)、内毒素(LPS)、丙二醛(MDA)、氧化蛋白产物(AOPP)]水平。结果观察组治疗总有效率为96.00%,明显高于对照组的78.00%,差异有统计学意义(P<0.05)。观察组大便潜血转阴时间、呕血消失时间、肠鸣音恢复时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组TNF-α、LPS、MDA、AOPP水平比较差异无统计学意义;治疗后,两组TNF-α、LPS、MDA及AOPP水平均明显低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为6.00%,明显低于对照组的28.00%,差异有统计学意义(P<0.05)。结论采用内镜下金属钛夹止血联合药物治疗非静脉曲张性上消化道出血效果确切,可有效改善患者临床症状及应激因子水平,值得临床推广应用。

Objective To explore the clinical efficacy of endoscopic metal titanium clip hemostasis combined with drugs in the treatment of non variceal upper gastrointestinal bleeding.Methods A total of 100 patients with non variceal upper gastrointestinal bleeding admitted to our hospital from October 2019 to October 2020 were selected as the research subjects,and they were divided into the control group and the observation group according to random number table method,with 50 cases in each group.The control group received endoscopic drug hemostasis treatment,while the observation group received metal titanium clip hemostasis treatment on the basis of the control group,the clinical efficacy,recovery,stress factors(tumor necrosis factor s-α[TNF-α],lipopolysaccharides[LPS],malondialdehyde[MDA],advanced oxidation protin products[AOPP])levels before and after treatment were compared between the two group.Results The total effective rate in the observation group was 96.00%,which was significantly higher than the 78.00%of the control group,the difference was statistically significant(P<0.05).The time of stool occult blood to turn negative,the time of hematemesis to disappear,the time of bowel sound recovery and the time of hospitalization in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in TNF-α,LPS,MDA and AOPP levels between the two groups;after treatment,the levels of TNF-α,LPS,MDA and AOPP of the two groups were significantly lower than before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 6.00%,which was significantly lower than 28.00%in the control group,the difference was statistically significant(P<0.05).Conclusion The use of endoscopic metal titanium clip hemostasis combined with drugs for non variceal upper gastrointestinal bleeding has a better hemostatic effect,can effectively improve clinical symptoms and stress factor levels,and is worthy of clinical promotion and application.